Rolle Teresa, Dallorto Laura, Bonetti Beatrice
Eye Clinic, Department of Surgical Sciences, University of Torino, Torino, Italy.
Invest Ophthalmol Vis Sci. 2016 Oct 1;57(13):5772-5779. doi: 10.1167/iovs.15-18882.
To evaluate the ability of total and macular estimated retinal ganglion cell (RGC) counts to discriminate between healthy and glaucomatous eyes. To determine threshold markers of the estimated RGCs taking into account age dependence.
This was a cross-sectional, observational study. The study group consisted of 176 eyes subdivided in three groups: 32 healthy, 91 preperimetric (PPG), and 53 primary open-angle glaucoma (POAG) eyes. The estimate of total and macular number of RGCs was obtained using a model described later. To account for the inverse correlation of RGC count with age, we considered two age subgroups (≤55 and >55 years) for both total and macular estimated RGC counts. We computed frequency distributions and receiver operating characteristic (ROC) curves to measure the discriminating ability and derive the cut-offs between two different conditions with their relative diagnostic parameters.
The total and macular estimated RGC counts showed highly significant differences among the three groups (P < 0.0001). The estimated RGC counts performed fairly well in distinguishing healthy from glaucomatous (PPG+POAG) eyes (area under the curve [AUC] = 0.79-0.92) with no statistically significant difference between total and macular RGCs. The approach allowed a good discrimination also between PPG and POAG eyes (AUC = 0.86-0.92). Cutoffs for the older age bracket were found to be lower in all cases.
Retinal ganglion cell counts estimated with empirical formulas with RTVue-100 could be used as a valid surrogate for neural losses in glaucoma.
评估视网膜神经节细胞（RGC）总数及黄斑区RGC计数区分健康眼与青光眼眼的能力。考虑年龄依赖性，确定估计RGC的阈值标记。
这是一项横断面观察性研究。研究组由176只眼组成，分为三组：32只健康眼、91只视野检查前期（PPG）眼和53只原发性开角型青光眼（POAG）眼。使用后文所述模型获得RGC总数及黄斑区RGC数量的估计值。为了考虑RGC计数与年龄的负相关，我们针对RGC总数及黄斑区RGC计数估计值，将年龄分为两个亚组（≤55岁和>55岁）。我们计算频率分布和受试者工作特征（ROC）曲线，以测量区分能力，并得出两种不同情况之间的临界值及其相对诊断参数。
三组之间RGC总数及黄斑区RGC计数估计值显示出高度显著差异（P<0.0001）。估计的RGC计数在区分健康眼与青光眼（PPG+POAG）眼方面表现良好（曲线下面积[AUC]=0.79-0.92），RGC总数与黄斑区RGC计数之间无统计学显著差异。该方法在区分PPG眼和POAG眼方面也表现良好（AUC=0.86-0.92）。在所有情况下，发现年龄较大亚组的临界值较低。
用RTVue-100经验公式估计的视网膜神经节细胞计数可作为青光眼神经损伤的有效替代指标。
